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Relapsing-Remitting Multiple Sclerosis — SCE Neurology MCQ

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ModerateMultiple Sclerosis & CNS InflammationRelapsing-Remitting Multiple SclerosisSCE Neurology

A 28-year-old woman is diagnosed with clinically active relapsing-remitting MS. She has had 2 relapses in the past year with MRI evidence of new T2 lesions. She is JCV antibody negative. Her neurologist discusses disease-modifying therapy. Which treatment is most appropriate as first-line high-efficacy therapy per current NHS commissioning?

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Correct answer: D — Ocrelizumab

Explanation lettering: D = shown as A · A = shown as B · B = shown as C · C = shown as D

Ocrelizumab (anti-CD20) is approved by NICE (TA533) for active relapsing MS. It is a high-efficacy DMT suitable as a first-line option. The NHS England treatment algorithm supports early high-efficacy treatment, particularly in patients with active disease (2 relapses with MRI activity). A/B: Interferons and glatiramer acetate are moderate-efficacy platform therapies. D: Dimethyl fumarate is a moderate-efficacy oral agent. E: Teriflunomide is a moderate-efficacy oral agent.

Reference: NICE TA533 Ocrelizumab (2018); NHS England MS Treatment Algorithm (2024)